Musculoskeletal Biomechanics: Diagnosis and Treatment

"After graduating from university, I had a solid foundation of techniques to address patients' problems, and with this, I began my work as a rehabilitation specialist.

However, I wasn't fully satisfied; my skills delivered good results in the "here and now," but I couldn't grasp the underlying causes of the symptoms, and the patients' problems would reappear over time.

I attended many continuing education courses, and eventually, I arrived in Paris, where I met F. Mézières and her Method. There, I delved deeply into musculoskeletal biomechanics, which allowed me to gain a comprehensive understanding of both the symptoms and, more importantly, the causes behind them.

It’s not a simple approach, and it requires time and dedication to learn it in all its potential.

However, the initial challenges were more than compensated by the therapeutic results and patient satisfaction. I now have in my hands an effective tool for both clinical reasoning and therapeutic strategies."

Mauro Lastrico

The online course offers the same theoretical and practical topics as the in-person course. It is structured with 18 videos in asynchronous mode, with a total duration of about 38 hours, that learners can view at any time, even multiple times, for up to 12 months. The videos offer both theoretical content accompanied by images and practical demonstrations. The instructors are Dr. Laura Manni and Dr. Mauro Lastrico, physiotherapists trained directly in Paris by Françoise Mézières, starting in 1988.

Their production was entrusted to a professional film crew, Clipper Media SAS, to ensure the best quality and usability of the videos. We thank them for their help and expertise in filming and dubbing. The dubbing from the Italian version to the English version was performed by professional actors.

After the course, a qualifying certificate will be issued by AIFiMM (Italian Association of Physiotherapists for the Study and Development of the Mézières Method - Higher Institute of Neuro-Myofascial Biomechanics). AIFiMM is recognized by the Italian Ministry of Health as a provider of CPD professional update training for healthcare practitioners.

Dedicated to physiotherapists, osteopaths, chiropractors, and doctors, this training complements Françoise Mézières' rehabilitation program with current posturology and biomechanics knowledge.

This course represents an invaluable opportunity for manual therapists to learn how to effectively apply Mézières' method and its innovative techniques to posture-related musculoskeletal issues. This training aims to provide students with the necessary theoretical and practical tools for interpreting postural disorders and identifying suitable strategies for their resolution. The key aspect of this course is the practical application of the methodology, which focuses on the recovery of the physiological functionalities of the neuro-myofascial system, allowing for an adequate approach and appropriate problem-solving strategies.

For any information, please send an email to: info@aifimm.it

THE METHOD

There is a broad spectrum of orthopedic conditions, some related to trauma or congenital conditions, while others seem to arise from independent causes. Among these are scapulohumeral impingement, osteoarthritis, knee deformities such as varus/valgus knees, and issues like flat feet or high arches, sciatica, radiculopathies, and disc compressions, to name just a few. Each of these conditions requires specific therapeutic protocols.

Françoise Mézières, a French physiotherapist, formulated an interesting insight based on her empirical observations: the connective tissues within muscle fibers tend to shorten, consequently reducing the length of the muscles themselves.

From this, a common cause for various orthopedic pathologies emerges: when muscle attachments move closer together due to shortening, the bone structures can only adapt by altering the physiological joint sequences (such as varus/valgus knees, scapulohumeral impingements, vertebral sinusoid deviations, etc.), also leading to compressive phenomena within the joints, intervertebral discs, and nerve roots.

From these considerations, two simple equations can be formulated:

• In the absence of significant skeletal deformities, whether congenital, acquired, or due to trauma, the skeleton adapts to the sum of the shortening of the muscular system, giving rise to various pathologies due to sequential alteration, joint, disc, or root compression.
• In the presence of significant skeletal deformities, whether congenital, acquired, or due to trauma, it is the muscular system that must adapt. This adaptation will affect the unaffected joints, giving rise to new issues.

This perspective offers an important differential diagnostic tool, and the therapeutic response is a logical consequence.

Through active exercises performed by the patient, the aim is to reduce the resisting force of the muscular system (determined by the shortening of the connective components within the muscle fiber) in favor of its Work capacity (elasticity, dynamism, physiological length).

This process restores the balance of force between agonist and antagonist muscles, promoting the recovery of physiological joint sequences and decompression within the joints, intervertebral discs, and nerve roots.

This therapeutic approach results in the resolution of both the symptoms and underlying causes of orthopedic pathologies, promoting well-being and the recovery of functionality.

In conclusion, the Mézières Method stands out as an excellent rehabilitative technique and is a fundamental pillar of every professional's skills in the field of rehabilitation.

TRAINING

The training in the Mézières Method offered by AIFIMM stands out for its commitment to following the principles of Evidence-Based Medicine (EBM), ensuring a scientifically valid and measurable therapeutic practice. Here’s how we do it:

• Scientific Foundations: Every theoretical topic is thoroughly explored and supported by solid physical laws. This ensures that students gain a deep understanding of the fundamental principles of the Mézières Method, based on well-established scientific knowledge.
• Active Patient Involvement: The Mézières technique is a form of active therapy where the patient is directly involved in the process under the expert guidance of the therapist. Through targeted and specific exercises, patients become protagonists in their healing journey, which can increase the effectiveness of the treatment.
• Objective Evaluation of Effectiveness: We carefully measure the effectiveness of therapeutic exercises by comparing results before and after treatment. This data-driven approach provides an objective assessment of the patient's progress, allowing therapists to timely and accurately adapt and optimize the treatment plan.

Additionally, the Italian Association of Physiotherapists for the Study and Development of the Mézières Method is the primary reference point for those wishing to deepen their knowledge of this methodology. Here’s why you should consider joining us:

• Ministerial Authorization: We are the only Mézières Method training institution in Italy authorized directly by the Italian Ministry of Health as ECM Provider No. 1701.
• Prestigious Faculty: Our faculty includes direct students of Françoise Mézières, such as Dr. Laura Manni and Dr. Mauro Lastrico. These experts obtained their specialization at the Centre Formation Mézières in Paris, ensuring high-level teaching and the authentic and profound transmission of knowledge in the Mézières Method.
• Continuous Evolution: Our instructors are committed to the constant evolution and improvement of the Mézières Method, actively contributing to the scientific rationalization and updating of its theoretical content in line with Françoise Mézières' latest practical discoveries. It is important to note that the methodology has undergone multiple modifications by its creator, up until the final version on which our instructors were trained. Their experience and expertise ensure that the Mézières Method remains at the forefront of rehabilitative therapy.
• Targeted Clinical Approach: AIFIMM instructors are highly qualified in in-depth clinical case analysis, ensuring that students correctly identify therapeutic objectives and the methods to achieve them. This ensures personalized and effective treatment for each patient, promoting optimal results in the contemporary clinical setting.

Join us for an exceptional training experience in the Mézières Method. With the training offered by AIFIMM, you will have access to a pathway that will provide you with a solid foundation of skills and knowledge. Join our community and advance your professional career with confidence and authority!

INSTRUCTORS

From the initial insights in 1947 to the refinements of the latest versions in the late 1980s, the Mézières Method underwent a profound evolution guided by its creator, Françoise Mézières herself.

AIFiMM instructors, Dr. Mauro Lastrico and Dr. Laura Manni, had the honor of being direct students of Françoise Mézières from 1988 until the period just before her passing. This close relationship allowed them to witness the latest developments and refinements of the method.

As independent professionals, Lastrico and Manni have dedicated their entire careers to the study, application, and adaptation of the Mézières Method to the latest scientific discoveries. Their mission has been to transform an initially empirical approach into a therapeutic practice based on solid scientific foundations.

The contribution of AIFiMM instructors to the advancement of the Mézières Method has manifested in several ways:

• They have conducted a scientific rationalization of the Method's content, based on biomechanical and physiological principles, to ensure accurate and effective therapeutic practice.
• They have introduced the latest discoveries in the fields of posturology and rehabilitation, integrating them into the context of the Mézières Method to further enhance therapeutic outcomes.
• They have developed a rigorous clinical reasoning process to precisely identify therapeutic objectives and the means necessary to achieve them, ensuring personalized and targeted treatment for each patient.

In summary, the contribution of AIFiMM instructors represents an important piece in the evolution and establishment of the Mézières Method as a therapeutic practice of excellence, founded on solid scientific principles and advanced clinical skills.

ACQUIRED SKILLS

The Mézières Method is not just a series of therapeutic exercises but also a powerful tool for differential diagnosis, essential for identifying the underlying causes of various pathologies. During the course, participants will develop advanced skills to conduct:

• A detailed and comprehensive patient examination, both analytically and systemically, in static and dynamic conditions.
• An in-depth biomechanical evaluation of the spine and all mobile joints to identify dysfunctions and misalignments.
• A differential assessment of pathologies, distinguishing those of myofascial origin from those of other structures.

Additionally, participants will acquire practical skills to therapeutically address a wide range of disorders, including:

• Spinal alterations such as scoliosis, hyperlordosis, kyphosis, intervertebral disc compressions, radiculopathies, sciatica, cervicobrachialgia, and more.
• Joint disorders, including osteoarthritis, shoulder impingement syndrome, hip osteoarthritis, and others.
• Muscular problems such as lower back pain, stiff neck, myalgias, and similar conditions.
• Dysmorphic anomalies such as jaw blockages or subluxations, genu varum/valgum, flatfoot/high arch, hallux valgus, and more.

The training course offers a balance between theory and practice, allowing students to gain in-depth knowledge and practical skills.

Particular emphasis is placed on clinical reasoning, enabling students to set rational therapeutic objectives and select the most appropriate strategies to achieve them.

Upon completing the course, students will be able to independently and effectively apply the Mézières Method, having acquired a solid theoretical understanding and significant practical experience.

The Mézières Method courses offered by AIFiMM adhere to the hour requirements established by Françoise Mézières herself, ensuring a comprehensive training pathway that meets the highest standards.

• Mézières Method: Introduction
• Scientific parameters
• Physics and muscular vectorial analysis
• Myofascial biomechanics
• Dynamic and static balance
• Sinusoidal vertebral subdivision based on myo-functional basis
• The reference anatomical model
• The "correct" posture following the Mézières Method principles
• Biomechanics and differential vectorial analysis of the cranial-cerebral-sacral tract from the sagittal plane: Theory and practice
• Biomechanics and differential vectorial analysis of the scapulo-costal-vertebral and scapulo-humeral relation: Theory and practice
• Static, visual, and palpatory objective examination from standing and supine positions: Theory and practice
• Linear and non-linear physics
• Complex systems: definition and characteristics
• Muscular chains
• "Physiological" and "functional" causes for body symmetry loss
• "Advance" and "rear" antalgic reflexes
• Torque forces
• Dynamic, visual, and palpatory objective examination from standing position, forward flexion, and supine position: Theory and practice
• Deep tissue massage and manual techniques of myofascial harmonization following the Mézières Method: Theory and practice
• Introduction to therapeutic breathing: Theory and practice
• Supine work, sagittal plane, for the correction of:
• Cranium
• Hyoid bone
• Cervical lordosis
• Thoracic kyphosis
• Lumbar lordosis
• Pelvis
• Scapulo-vertebro-costal rhythm
• Gleno-humeral rhythm
• Theory and practice
• Supine with elevation of lower extremities work: Theory and practice
• Biomechanics and differential vectorial analysis of hip and knee
• Hip and knee treatment
• Biomechanics and differential vectorial analysis of talo-crural joint and foot
• Talo-crural and foot treatment
• Sitting work: Theory and practice
• Mézières assessment and treatment following the techniques covered so far
• Biomechanics and differential vectorial analysis of:
• Cranio-vertebro-sacral tract
• Hyoid-vertebro-scapular rhythm
• Scapulo-vertebro-costal rhythm
• Gleno-humeral rhythm
• Upper extremities
• Frontal and rotational plane: Theory and practice
• Correction maneuvers for:
• Cranio-vertebro-sacral tract
• Hyoid-vertebro-scapular rhythm
• Scapulo-vertebro-costal rhythm
• Gleno-humeral rhythm
• Upper extremities
• Frontal and rotational plane: Theory and practice
• Supine position treatment:
• Cranio-vertebro-sacral tract
• Hyoid-vertebro-scapular rhythm
• Scapulo-vertebro-costal rhythm
• Gleno-humeral rhythm
• Upper extremities
• Frontal and rotational plane: Theory and practice
• Treatment from supine position with elevation of lower extremities and from sitting position:
• Cranio-vertebro-sacral tract
• Scapulo-vertebro-costal rhythm
• Gleno-humeral rhythm
• Frontal and rotational plane: Theory and practice
• TMJ and posture: links and connections: Theory and practice
• TMJ dysfunction treatment: Theory and practice
• Dynamic postural examination
• Biomechanics and differential analysis of sterno-clavicular and gleno-humeral subluxations: Theory and practice
• Treatment of sterno-clavicular and gleno-humeral subluxations: Theory and practice
• Guidelines: from the postural examination to the treatment plan. Identification of the primary therapeutic objectives: Theory and practice
• Scoliosis and orthopedic spinal pathologies treatment following the Mézières Method
• Mézières assessment and treatment following the techniques covered during the whole course